Korean Circ J.  2013 Apr;43(4):215-220. 10.4070/kcj.2013.43.4.215.

Aortopathy in Congenital Heart Disease in Adults: Aortic Dilatation with Decreased Aortic Elasticity that Impacts Negatively on Left Ventricular Function

• Niwa K

• KMID: 2224942
• DOI: http://doi.org/10.4070/kcj.2013.43.4.215

Abstract

Bicuspid aortic valve and/or coarctation of the aorta are consistently associated with ascending aortic and para-coarctation medial abnormalities. Medial abnormalities in the ascending aorta are prevalent in other types of patients with a variety of forms congenital heart disease (CHD), such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, tetralogy of Fallot. These abnormalities encompass a wide age range, and may predispose to dilatation, aneurysm, and rupture that necessitates aortic valve and root surgery. This dilatation can develop in CHD patients without stenotic region. These CHDs exhibit ongoing dilatation of the aortic root and reduced aortic elasticity and increased aortic stiffness that may relate to intrinsic properties of the aortic root. The concept of aortic dilatation is shifting a paradigm of aortic dilatation, as so called post stenotic dilatation, to primary intrinsic aortopahy. These aortic dilatation and increased stiffness can induce aortic aneurysm, rupture of the aorta and aortic regurgitation, but also provoke left ventricular hypertrophy, reduced coronary artery flow and left ventricular failure. We can recognize this association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction as a new clinical entity: "aortopathy".

Keyword

Aortic disease; Congenital heart defects; Cystic medial necrosis of aorta; Tetralogy of fallot

MeSH Terms

Aneurysm
Aorta
Aortic Aneurysm
Aortic Aneurysm, Thoracic
Aortic Coarctation
Aortic Diseases
Aortic Valve
Aortic Valve Insufficiency
Arteries
Bicuspid
Coronary Vessels
Cysts
Dilatation
Elasticity
Heart
Heart Defects, Congenital
Heart Diseases
Heart Valve Diseases
Humans
Hypertrophy, Left Ventricular
Hypoplastic Left Heart Syndrome
Polymethacrylic Acids
Rupture
Tetralogy of Fallot
Truncus Arteriosus, Persistent
Vascular Stiffness
Ventricular Function, Left
Aortic Aneurysm, Thoracic
Aortic Valve
Cysts
Heart Valve Diseases
Polymethacrylic Acids